B超颅外探查在颅内血肿微创清除术中的应用研究

B- type ultrasonic inspection in the minimally invasive surgery in patients with hypertensive intracerebral hemorrhage

目的总结B超探察技术在高血压脑出血患者颅内血肿微创清除术中的临床应用疗效。方法选择2007～01～2008—12我科收治的40例高血压脑出血拟行颅内血肿微创清除术的患者作为研究对象。将患者随机分为两组，A组（B超引导组）20例，利用YL-1型一次性颅内血肿粉碎穿刺针在CT定位、B超引导下清除血肿；B组（对照组）20例，只CT定位下清除血肿。分别观察两组患者血肿清除率、术中发现大血管例数、再出血率、临床治愈率、住院天数及住院费用。结果A组患者首次血肿清除率64．7％，总清除率92％，优于B组（首次血肿清除率36．5％，总清除率89％）；A组术中发现大血管例数多，再出血率明显低于B组；A组治疗基本痊愈和显著进步比率高于B组，恶化和死亡比率显著低于B组；A组平均住院时间、平均住院费用减少。结论将B超探察技术应用于高血压脑出血患者颅内血肿微创清除术，可发现并避开脑组织表面的大血管，降低操作过程的盲目性，从而降低再出血的发生率，减少住院时问，降低住院费用和死亡率。

Objective To evaluate the effects of B - type ultrasonic inspection in the minimally invasive surgery of the patients with hypertensive intracerebral hemorrhage. Methods 40 patients with hypertensive cerebral hemorrhage who underwent minimally invasive removal of intracranial hematoma were included. They were randomly divided into 2 groups ： B - type ultrasonic inspection group （ group A） and control group （group B）. Outcome measurements were as follows： hematoma rate, the cases of major vascular found in the surgery, rebleeding rate, clinical cure rate, hospital stay and hospital costs. Resu/ts Hematoma rate of first time was higher in group A than in group B （64. 7% vs 36. 5% P 〈 0.05 ） , while rebleeding rate was lower in group A than in group B. Compared with group B, patients of group A had less hospitalization and lower hospital costs （ P 〈 O. 05 ）. Conclusion Using B - type ultrasonic inspection before the minimally invasive surgery in patients with hypertensive intracerebral hemorrhage, we avoid the major vascular on the surface of brain, get low feb]ceding rate, decrease hospitalization and hospital costs.